Trauma and Healing for Physicians with Integrative Psychotherapist Francine Kelley

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“Part of it is reconnecting mind to body and to be aware of how my body reacts and to connect that with what I’m feeling and how to put words to it.” -Coach Gabriella Dennery MD

In today’s episode, Coach Gabriella Dennery MD has an in depth talk with Francine Kelley, LCPC, RYT500, SEP about trauma and healing from trauma. Francine is a Jamaican-born integrative psychotherapist based in Chicago, IL. Her collaborative style combines yoga, mindfulness, meditation and other somatic and energetic approaches to provide clients with a broad range of options for healing traumatic wounds and experiencing their true selves. Trained in Somatic Experiencing, Sensorimotor Psychotherapy, Trauma-Sensitive Yoga, Trauma-Informed Yoga Therapy, LifeForce Yoga, Reiki and somatic touch, Francine is fascinated by scientific, energetic and spiritual perspectives on healing. And in this episode she gives us actionable tips we can use in the moment to center and ground ourselves back in the here and now. Tune in to find out how you can get on the path towards healing today. 

As a workshop facilitator and trainer, Francine has presented nationally and internationally to mental health and medical practitioners on the topic of mind/body approaches to health and healing. Francine is a co-developer of the 24-week Integrative Trauma Recovery (ITR) group process which combines DBT, somatic approaches, yoga skills and psychoeducation to help trauma survivors gradually move toward a more knowledgeable and empowered involvement in their recovery from trauma.

She can be contacted at 872-216-7797 or [email protected] 

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Please enjoy the full transcript below

Gabriella: Part of it is reconnecting mind to body and to be aware of how my body reacts and to connect that with what I’m feeling and how to put words to it.

 

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Gabriella: Hi, my name is Gabriella Dennery, MD, life coach at DocWorking, and welcome to DocWorking: The Whole Physician Podcast. I’m absolutely excited to bring my next guest today because I think we’re going to have a really good conversation about one of the missing links to approaches to treatment of trauma. And this is very salient, very relevant for physicians who may be dealing with burnout. And one of the outcomes of burnout, as many of you know, is PTSD. And so, I want to welcome to DocWorking: The Whole Physician Podcast, Integrative Psychotherapist, Francine Kelley. Francine, welcome.

 

Francine: Thank you, Gabriela, it’s great to be here. Thank you for having me.

 

Gabriella: Oh, thank you for being here, because you are a specialist in what is called Somatic Experiencing, or therapy based in Somatic Experiencing, and other somatic modalities in helping people dealing with trauma. And you have facilitated workshops nationally and internationally to medical professionals relating to that, to these kind of integrative approaches to treatment of trauma. Before we get into that detail, can you share with us exactly what inspired you to get into this kind of work?

 

Francine: Wow. So that’s a long story, and it’s always so interesting where to start, because I feel like so much of the work that we do is based on our history, and what we needed, in order to feel healthy to feel well. I guess, I’ll start with, I was a yoga instructor, and yoga is something that I had the honor of being introduced to as a child growing up in Kingston, Jamaica, which you might recognize in the 1970s was a pretty odd sort of occurrence. But as a yoga teacher, I had learned how to track the whole body, to look at people and their whole experience. 

 

Psychotherapy is actually my second career. I was a database manager for a decade. And then I had two kids, and all of a sudden, I didn’t want to do databases anymore. So, I went back to graduate school to study counseling. And as I was doing my practice sessions, as a student, as I was doing my internship at a domestic violence shelter, I realized that even as I was talking to people, which is what we were trained to do, there was something happening in their body, there were gestures that were happening, there was postures that were shifting, people were saying one thing, but their bodies, were doing something else. That’s a familiar thing, I’m sure for physicians, and for therapists. I thought, “Okay, something’s going on here, and I need to know how to do this.” 

 

I went looking, I thought I would have to figure it out myself. How do I integrate yoga? Even doing a little bit of yoga with the women at the shelter, it was like– I remember teaching, a basic breathing technique, and a little bit of stretching, and their eyes got really big. And they were like, “Oh, my gosh, what is this?” I wanted to know, how do I do this? I started doing some research, and I found out that there were trainings in yoga as an adjunctive, to treating trauma, PTSD, and also that there were these somatic therapies that were available that already did the thing that I wanted to have happen. I actually studied somatic experiencing, and also sensorimotor psychotherapy, which is another somatic psychotherapy method.

 

Gabriella: What is somatic? 

 

Francine: Somatic is basically of the body. We recognize that there is an experience– our emotions happen in our bodies. How do you know you’re happy? Your smile, your facial expression changes, that’s physiological. There’s an opening of your chest. If you’re excited, you might get butterflies in your stomach. If you’re scared, then your body might tighten, your jaw might tighten. If you’re angry, your eyes get really big. Our emotions are actually physiological experiences that we give names to, we call them emotions. In some cultures, there isn’t a different word for a feeling versus the sensation. The word that denotes emotion includes the physiology that comes with the emotion.

 

Gabriella: What’s the drawback of separating the two is there? We’re in the place and in a time where there is this need to and even in myself as I’m continuing to heal the aftermath of PTSD, which I burnt out as a primary care physician, and I’m still realizing that after all these years of having stepped away from clinical medicine, that I’m still dealing with the after effects. Part of it is reconnecting mind to body and to be aware of how my body reacts, and to connect that with what I’m feeling and how to put words to it. Why is this important to make that connection?

 

Francine: That’s a great question. What’s the drawback of separating mind from body? Well, the first drawback is that we’re not our whole selves, because you’re not a separate mind and body. When you leave your house, your whole system goes with you. When I talk about emotions happening in the body, our reactions to our life experience are happening, not just in our minds, but in our physiology as well. If we’re just trying to think our way out of activation, what we call activation, anxiety, anger, stress, worry, if you’re trying to think your way out of it, then it’s actually– I want to say it’s hard, because emotions are very hard to corral. But your physiology– so I mentioned, okay, if I’m getting anxious, then my shoulders might creep up. 

 

Now, my brain is also tracking my physiology to see how things are going. As my shoulders are creeping up, there’s a part of my consciousness that’s tracking that that’s going, “Oh, something must be wrong.” Now I really start to get anxious. The alternative to that is my shoulders start creeping up, I’m aware of that. “Ah, I allow my shoulders to let go.” And now there’s a different experience that’s happening overall. And that’s just a really simple example. Of course, it’s more complex than that, but it means that we don’t have to be victims of the experience that’s happening in this part of our system. We can notice it, we can track it, we can do something about it. When I settle what’s happening here, then the message to the tracking part of my brain is, “Oh, okay, things are all right, you know, we don’t have to escalate here.” Does that help? 

 

Gabriella: I think that helps. What I’m hearing you say is that noticing what your body is doing? I mean, our body will always react and tell me if this is wrong or right, our bodies react before our brain even knows what’s going on? Would that be a correct assessment? 

 

Francine: Yeah. I actually read about a study once. I’m trying to remember where I heard about this. But these people were on a safari, and someone was sitting with a child in the back, and instantaneously went and rolled the window up. This is the story as I remember it. And soon after that, something came up into their view that was threatening. We’re tracking all the time. Stephen Porges calls it Neuroception. We’re always tracking our environment. We’re tracking other people in our environment. Our systems are constantly checking to see what’s going on out there, in here. But we’re not always aware that we’re doing that. We react out of whatever it is that we’re picking up subconsciously. We react if that was something threatening in the past if it’s novel, because we react to novelty as well. And depending on how new things affected you in the past is whether you’re going to be like, “Oh, cool, a new thing,” or your system is going to go, “Something’s wrong, something’s wrong, I need to be vigilant.” Also, sometimes we’re just living in vigilance.

 

Gabriella: Let me stop you here, because I think that that brings up a really, really good point. You talked about activation, and let’s go into what that means a little bit. You said that the brain doesn’t make a difference between being activated from a past event, or being activated from a memory of a past event or something that recalls that memory in the present. The brain doesn’t make the difference between past or present. And so as you said, we could be walking with that activation 24/7, or that sense of stress 24/7. Tell me about what is activation?

 

Francine: Okay, very good question. When I work with clients, it helps for us to have a way of understanding. We’d like to know what’s going on. I always say if we can understand what’s happening in us, if we have words to describe what’s happening, and ways to shift that, then we’re not victims of our own experience. What is activation? We’ve all heard a fight or flight response, so that’s part of it. The ways that we respond to something that strikes our systems as potentially unsafe, potentially threatening. We might go into fight, we might go into flight, but there’s more to it than just that. We may also freeze. I can’t fight, I can’t flee, this threat feels so big, that I have to just be really, really still because so many of our responses come from the olden days, if you will. 

 

When we were dealing with predators, we are animals. Our systems operate very much on a mammalian response. We are animals in the end, even though we have these wonderful courtesies that help us to reason. Sometimes, that actually gets in the way. Okay, so fight, flight, I might go into freeze. Yeah, all of that we call activation. What else could happen though, is I might decide that the best way to deal with this potential threat, is to appease and appeasement, it’s a way that we try to make ourselves safe. Yeah, all of these responses get a bum rap, I always say, because they’re all very natural ways of dealing with threat. We should be able to deal with the threat, once the threat is over, we get to settle again. That’s the idea. One of the things in somatic experiencing that Peter Levine elucidated was what we call a Threat Response Cycle, where we recognize a threat, we orient to the threat and we respond to it. And once we respond to it, all those neurotransmitters that came up, all the biochemicals that came up to help us to move into fight, or flight or freeze, sometimes we fold, we might collapse. All of that biochemistry gets discharged, either by us shaking or laughing, or sometimes it’s just a small reaction, but we discharge and then we’re able to come back to that original state of exploratory orienting, we call it, where I’m feel like, “I’m okay, I can move through the world, threats might come, but I can deal with them.” 

 

Each time we face a threat, it’s like, with a pathogen. When a pathogen attacks, your system goes into creating antibodies to deal with that. Once you’ve fought it off, the next time, the system knows what to do, it has built capacity for it. We’re designed similarly where we can build capacity for threat. When we get interrupted in that threat response cycle, when something happens, and we’re not able to complete our defense, or we didn’t see that threat coming, or it’s just so much that we feel overwhelmed, from a somatic lens, we really look at trauma, as overwhelmed to the system. When we feel overwhelmed, and we’re not able to deal with it, in the way that helps us to move through and to build our capacity, then, in our view, that’s when we end up with PTSD.

 

Gabriella: If I’m understanding correctly, it means that there’s a point where we blunt the response or the natural response to how to deal with a traumatic event or experience or traumatic activation or trigger a memory, it doesn’t go all the way to completion. And that’s where we get into trouble, such as PTSD, or other, would you say that things like depression, anxiety, stays in the body for that reason as well, that the responses to trauma don’t get resolved?

 

Francine: Yeah, there’s something that wanted to happen, that didn’t get to happen. Maybe least threat, at a lower level of threat. You wanted to say something to someone, and you didn’t get to say it. So, there’s this buildup of defense that never gets to be expressed.

 

Gabriella: It never gets to be expressed, it goes somewhere else. 

 

Francine: Where does it go? 

 

Gabriella: In the body.

 

Francine: Yes, that’s where it goes, that’s somewhere else. It never goes anywhere. Anger is one of those things, especially there’s so many ways that we’re also trained into, “Well, you’re not supposed to feel that you’re not supposed to be angry. God knows you can’t be angry at a patient.” Of course, you can’t do that in the space of the interaction. But when you leave, what happens then? Often what happens then, is we beat ourselves up. I’m not supposed to feel this, like all the messages that we have about how to be good people. If we even notice that it has built up in our system, because oftentimes, we ignore it. There’s so many ways in sensorimotor psychotherapy, they talk about adaptive strategies, which are like the ways that we try to adapt and these strategies we usually learn them really early on, like, in our family system, this is how I’m going to adapt to.

 

So many of these responses, again, are tied up in our adaptive strategies. If I had to freeze, because I lived in an environment where there was intermittent explosivity, maybe from a parent, and I learned that the best way to be safe was just to be really still. I didn’t bring any attention to myself. Then that might end up being the strategy that I use when a patient is angry at me, or when I don’t know what to do when I get that sense of activation comes. Yeah, so that we get to start to learn to recognize that in ourselves, that’s part of what I love about this work, is that because you’re paying attention, what’s actually happening in my physiology right now? Are my shoulders coming up to my ears? Did I just stop breathing? Am I collapsing? Is my whole body going into collapse? 

 

As we start to pay attention to that, what helps me when that happens, because oftentimes, there isn’t an actual threat, we might be perceiving a threat. And so, like you said, so the body responds to a perceived threat, that’s based likely on something from the past. Can I come back to the present moment and what is actually happening here? 

 

Gabriella: Right, exactly.

 

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Gabriella: So, what would be, because I’m also trying to make the differentiation between, as you said in the beginning, we can’t think our way out of trauma, but there is some thought involved, I guess, as you– [chuckles] your shoulders are going up, “You go, “Oh, my shoulders are going up. Which choice am I going to go? I’m going to escalate the situation, get anxious about it? Or am I going to take a deep breath and relax?” Even if the circumstances around me haven’t changed, but my response to it changes. At the same time, when a person is activated, are there certain things that they can do right away to help alleviate some of the anxiety and the stress, particularly if that feeling of overwhelmed just is overwhelming and you can’t see anything, hear anything or understand anything? It’s just panic city, what would you recommend?

 

Francine: To answer your first question, you can’t think your way out of it in the sense of, there’s a difference between thinking and observing. I love it in the yoga system, and I know we’re going to talk about SE today, but I hope it’s okay that I bring in yoga because it’s all somatic. They figured that out thousands of years ago, but in the yoga system, we talk about the difference between automatic thoughts, and the observing self. Automatic thoughts is just that, like, my brain is running in reactivity. The observing self is this part of us that can pause, check in, “Ah, my shoulders are up to my ears.” [chuckles] I’m trying to talk about a lot of complexity. 

 

A simple thing then is, can I allow them to let go? What happens in my experience now? Or, I’ve stopped breathing? Can I notice that there’s plenty of air, and can I notice the tension that comes as I stopped breathing? As I allow that tension to let go, what happens now? But a big part of this also has to do with, if I’m in danger right now, I need to respond to that threat. But so many times we have these reactions, and there isn’t an actual threat. So that being in the present moment, we talk about that with mindfulness and people are like, “Oh, okay, so I know I have to come back to the present moment.” But you can’t really check for threat, if you’re operating on the past. You can’t really check for a threat that you’re worried about is going to happen in the future, and that’s what happens. 

 

Someone said we are multidimensional beings. So, we literally operate our brains operate in the past and present in the future. Usually, we’re either in the past or in the future. We humans so seldom are actually right here right now, and that’s one of the things that also I love about somatic work is that we do it here and now. It’s not what did you feel when the trauma happened. It’s what’s happening in your system right now, as you think of that. And we only go to that if the person system has already had a capacity to continue to be in the present moment, as we think about difficult things that happened in the past.

 

Gabriella: What I’m hearing is someone has to be able to make room for that to have that capacity, because in the moment, it can’t necessarily happen that this new information comes in, it’s like, “Okay, well, what do I do? What strategy do I employ to bring myself out of this state of anxiety?” How would a person be able to break that cycle as quickly as possible?

 

Francine: [laughs] Because we want to do it quick, right?

 

Gabriella: Well, okay, let me– [laughs] You’re right, there’s the in the moment thing that is happening, something is triggered right away, or activated right away. And then, there’s how does a person develop these coping skills over time? Let me split that two therefore. 

 

Francine: I find what we call psychoeducation to be really, really helpful, of just like, here’s how your nervous system works. My system goes into sympathetic charge, like on a dime, or my system goes into shutting down on a dime. Just being able to understand that, so we can start to name, “Oh, this is what’s happening.” Like I said, in the beginning, in my experience, and in working with clients, when I have some way of just being able to go, “Ah, I understand what’s happening in this experience.” 

 

Another part of this is normalizing. This is how our systems are designed to work. If I’m activated, it’s not like I go, “What’s wrong with me? Why am I being activated?” I get to go, “Oh, okay. Something must have felt threatening to me. Something must have felt like a threat. Let me start to get curious now.” Curiosity. Curiosity is huge. 

 

Peter Levine says, “You can’t be curious and traumatized at the same time.” We get to notice, “Ah, okay, something’s going on right now.” In my yoga training one of the mantras that was given by Kriyanandaji, who was the head of the yoga school where I did my training, he said, “Isn’t that interesting?” But that’s not like, “I’m going to go into analysis and trying to figure this out.” This is a observing self. This is me stepping back from, “Oh, my gosh, oh, my gosh, oh, my gosh,” and going, “Oh, okay. That’s interesting.” And then we get curious what’s happening in the body. If something starts feeling, “Ah,” then I get to go, “Okay, this feels like activation? How is this activation showing up?”

 

Gabriella: I could imagine that knowing how my brain functions and used to function, I had to know why, why is this happening? Why am I getting there? Why am I sharing the way this is? I don’t understand, I shouldn’t be feeling this way. Rather than asking why, it’s to just say, “Hmm, that’s interesting,” to be that curious observer, no judgment? One of my teachers used to say, “No judgment, no heat,” we don’t increase the temperature. It’s just an observation, which means that I don’t actually have to know why.

 

Francine: At first, because when you’re trying to figure out why from that place of activation, when you’re trying to figure out why from that place, you just end up spinning. That’s not a place that we can actually make any kind of reason, we know what happens in sympathetic charge. Our cognition is not firing on all cylinders when we’re in high sympathetic charge. Also, we’re not relational in that place, either. There’s a challenge then of, “Okay. Can I self-regulate?” Which is step one. Eventually, what we also want to be able to do is build our capacity. But I often talk to clients about we’re building a toolkit for self-regulation. Back to the story I told about working at the shelter as a yoga teacher who says, “It doesn’t matter what you give someone, as long as you give them something.” If I felt I have some sense of being able to settle my own physiology in the moment, then, at least I’m not a victim, as I said before. And then at least I feel like, okay, there’s something I can do here. A, I understand. Yeah, this is sympathetic charge. I’m in fight or I’m in flight or I’m just like, “My anxiety has kicked up.” That means something must have happened that felt threatening or overwhelming. But before I addressed that, what can I do with this activation? 

 

Again, as long as you’re sure, in this moment, there’s no threat. If there’s a tiger chasing you, that sympathetic charge is totally understandable, you need to address that. If someone is attacking you, relationally or physiologically, then we want to be able to deal with that threat. Physical threats, yeah, we want to be able to fight or flee. One of the things that we do with somatic work is to bring those responses back online, because again, we have to have those responses online.

 

Gabriella: It’s a question of having these responses as part of your natural physiology, because we are human, we are mammalian, that’s what we do. If we need to run, we run. We still have to be able to garner that immediately. At the same time knowing when– if a tiger is coming after me, I don’t want to be sitting there thinking about, “Hmm, should I or shouldn’t run?” [laughs] “I wonder if I should run or curl up in the ball? [laughs] What should I do?” I just go, skedaddle. At the same time, in our day-to-day lives, it’s knowing that when we’re activated, as you said, how to self-regulate, because sometimes that activation is not necessarily appropriate to the moment, but it’s there. As you said, building that toolkit, which I love that phrase to building a toolkit for self-regulation, and that’s something that is learned over time. With the help, of course, the support of an SE trained therapist or integrative therapist who looks at mind and body in terms of healing trauma and healing wounds, and how to deal with activation in the moment. Does that sum it up a little bit? 

 

Francine: It does sum it up. I wanted to throw out just one other little quick grounding technique, which is, as I’m sitting, I can feel my seat under me. I can feel my feet on the floor. If you even want to just play with the edges for a second, to just feel the support or the chair that you’re sitting on the back of the chair? And is your body holding itself up, which is what we tend to do when we’re vigilant, or in this moment, when there’s safety. Can your body allow itself to just be held by the chair? And then sometimes it’s also a matter of when what’s going on in the body is too much. Can I focus on something outside of myself, that’s a little more resourcing or something, something pleasant, looking at the sky, looking at the face of a loved one, feeling that connection with someone who will hold you relationally. Not necessarily physically, although that’s really good too, because we regulate through touch, but being with someone who has the ability to become unsettled. Also, co-regulation, we’ll settle ourselves. 

 

Physicians especially have a challenge, because you’re going in and out quickly, and dealing with people whose nervous systems are already revved up because of whatever they’re dealing with physiologically, and we pick that up. When you’re with someone who’s got that charge, you might start to feel that even though it’s not yours, even though it has nothing to do with you, because we are relational beings, and we vibe off each other. Highly medical terms. We vibe up with each other. If I move into a space with someone whose nervous system is activated, then I’ll start to feel that but if I am not in touch with my own body, I’ll think that I’m activated, too, and not recognizing that I’m just picking up what’s in the field. Another reason to really be able to pay attention to our own selves is we get to go, “Is this mine? Or am I picking this up in the room?” And that way, my brain doesn’t start going, “Oh, I must be really anxious.” It’s like, “No, that’s not my anxiety.” I’m just resonating with what’s happening with this other person. And then when I walk out of that room, before I go to see my next patient, [exhales] I can allow myself to regulate, I can let go of the tension or whatever it might be that I started to feel, because my system was resonating with the other person in the room, because I don’t own it.

 

Gabriella: And it does take time. I’ve heard that before from other practitioners as well. Is it yours? And it takes a little while to understand the difference between the two, because it does feel like it’s mine. I don’t even realize I’m picking up somebody else’s energy. But if I was feeling fine five minutes ago, and now I’m feeling anxious, and I don’t know [laughs] why. 

 

Francine: Healthy change.

 

Gabriella: Exactly, something did change.

 

Francine: That’s another benefit of being present with the body because that’s where that’s happening. If you try to think your way through is that mine, what are you asking is that yours? But if you start to feel tension, and if you start to feel tightening. Sometimes you can even feel your body doing it and you look at the other person, you’re like, “Oh, okay,” you can see it in that. That’s the thing, the body gives you a concrete place to work with what’s happening in your emotional state. 

 

Gabriella: You find that working with physicians, that part of the challenge, perhaps, and I don’t want to generalize, is to go below the neck. In other words, [laughs] to connect mind and body so that the body becomes your friend. It becomes your gauge as to what is going on out there, because that’s our primordial system is what happens in the body. Working with healthcare workers, do you find that that’s been a challenge in getting that connection going? Or is that just a general thing of living in the Western world?

 

Francine: If you think about it, we get good at what we practice. How many years, a decade sometimes, do physician spend practicing being up here, but it’s what our society, as a whole, tends to value. If I can just power through or if I can just figure it out, then everything’s going to be okay. And some of this stuff is not figure-outable, because it’s not logical. It’s logical in one sense and it’s not in another. That’s where I feel like psychoeducation is so helpful. If you understand, the smell of this woman’s perfume reminds me of a teacher who yelled at me in elementary school. If you understand that triggers in the environment, could have to do with something that’s not in the present moment. Even if you don’t necessarily know what the trigger is, there’s a way that you get to go, “Oh, okay, something happened. I don’t know exactly what it was, but something happened.” 

 

Back to the question of, we tend to live in our heads. At this point in my career, people come to me because they want to do somatic work. They’ve already figured out that something’s going on in the body. But even then, it can be hard. People go, “Well, you’re telling me to check in with my body, but I don’t know what that means.” What does that mean? We’re checking, did something change in your facial expression? Is there some shift in your muscle tension or relaxation? Did your sense of presence shift? Do you feel like you’re all here? Or, not quite here? Are there emotions that showed up?” Like I said, emotions happen in here, and sometimes we can find those before we can notice body, we can notice the motion. And then like, “Are there sensations? Are there in our body sensations? Is there a movement that’s trying to happen in your system?” Those are some of the things that we can track to help us to notice body. 

 

For folks that have a hard time with that, sometimes just because you’re busy all day long, and this is not something that’s part of your routine. Sometimes, I’ll encourage clients that I work with to just set a little reminder on your phone for once an hour or put a little post-it on your screen that says, “Pause.” And the pause, we get good at what we practice, so all of these things are habitual responses, the pause can become a habit. If you pause once an hour and just notice, how am I doing right now? How’s my body? Am I breathing? [laughs] When was the last time I took a breath? Or like, yeah, do I feel like I’m here? Or, am I operating at 50 miles an hour? Can I sit back, feel my back against the chair, feel my seat on the seat of my chair, feel my feet on the floor? Ah,I can we just allow ourselves 15 seconds to take an out breath. Just notice five exhales, instead of your system revving, revving, revving, revving all day, instead you go up, you come down for 15 seconds. You go up, the next hour you come down. 

 

We start to cultivate this habit in the body of settling is okay for a little bit. Just 15 seconds, just five breaths, just a pause to notice. Can I feel myself? And then that starts to become a little more of a habit. What I used to do when we were in person, is as I would leave one client, I would just imagine that anything that I might have picked up, any activation in my system, that on the exhale, I was just allowing it to release down and out through my feet. Imagery, sometimes that works for some people. If you just keep doing that, just every now and then allow yourself to check in. I would ask the question, is there any anything in my body right now, or mind that’s available to just let go? 

 

Gabriella: Can I allow myself to let go? Or, somewhere in my body, in my mind, to just let it go and allow myself to be supported? When the imagery for me of the chair is being able to sit in the chair, feel my arms on the armrest, my feet on the floor, my shoulders come down, did I take a breath? Let me take a breath and just allow myself to, as you said, feel the chair. For me, it’s also another way of saying, “Do I allow myself to feel supported?” I love that imagery and I love that thought. 

 

Francine, to wrap things up, you talked about so much. My question to you is how would a clinician, a physician who is now at a point where they realize that whatever method they were using before, to try and deal with stress and trauma, and releasing stress and trauma, they may have worked, but perhaps were somewhat limited that they were ready to get to the next stage, really looking at somatic responses and how to build that somatic toolkit? Where would a physician find that resource?

 

Francine: traumahealing.com is the website that has a list of practitioners all over the world. That’s my place that they could go. As I said, there’s multiple different systems, and different things work for different people. For some people, I have a yoga class with a teacher that specializes in trauma sensitivity, so that they understand how to work with the nervous system through the yoga process, I think would also be great. Some people are like, “I don’t want to go to therapy.” And I get that. Also, the type of therapy that we do, and we’re not sitting and talking about the past, we’re really working with skills to help you to deal with what’s happening in the present. traumahealing.com. I mentioned Sensorimotor Psychotherapy is another system that I’ve been trained in, and they have a website as well. sensorimotorpsychotherapy.com.

 

Gabriella: If you don’t mind sharing about that, you have a group, which actually I said, “Pick me, pick me,” because I’m signing up to do just that. To develop that kind of tool kit. 

 

Francine: My colleague, Anita Mandley, and I developed what we call the Integrative Trauma Recovery group, it’s a 24-week group process that combines skills and frameworks, understandings from yoga, SE and DBT because I was also trained in dialectical behavioral therapy.

 

Gabriella: What is dialectical behavior therapy, in a quick nutshell?

 

Francine: DBT is developed by Marsha Linehan, it’s typically recommended for working with people that have been diagnosed with borderline personality disorder, which ultimately, is a complex trauma presentation. And the group, it’s a psychoeducational group, that also includes mindfulness-based interventions. It’s another skill building group. I taught DBT groups for years, and there’s a lot of value in DBT. And they’ve just more recently started to include the body, but Anita and I, we’re both SCPs, she was my trainer for DBT. We’ve put these skills together in really, we call a titrated way, so little bit at a time to build, because with trauma, if we try to throw too much at the nervous system at once, it’s too much. And if you come in and you haven’t worked with the body, for me to be like, “Okay, so let’s sit and just notice how that terrible thing that happened to you, is showing up in your physiology right now,” it creates more overwhelm. 

 

The group step says gently through with psychoeducation. Anita and I were thinking about how do we provide this information, because we can only see so many clients in a week. The group was a way to bring the topics that we use with individual clients into a group format, so that we can provide information and skills and experiential practices for people who are recovering from trauma that they can build their toolkit. 

 

Gabriella: How can people sign up for that or get in touch with you or Anita–?

 

Francine: Oh, my goodness. Yeah.

 

[laughter] 

 

Gabriella: You may have an onslaught. [laughs] Don’t forget, I’m the top of the list. [laughs] 

 

Francine: My website is francinekelley.com. I have a contact page on the website. The groups are typically smaller. One of the things that we’re interested in doing is training other clinicians to be able to run the ITR groups. Someone’s interested in learning how to do that, and they can contact me as well. 

 

Gabriella: What I love about this is a total like integrated approach that brings in the whole human being, body and mind to really work together, as opposed to one going in one direction, the other one going in the other direction. We’re trying to bring them together. And for people to have that toolkit as you said, that ability to put into practice in their own lives on a day-to-day basis, as they get a little better, they build that muscle gradually over time. As you say, to titrate up somebody’s ability to deal with activation or traumatic experiences or the aftermath rather of traumatic experiences, whether they’d be present or in the past. 

 

Francine Kelley, you are fabulous. And I hope that we can bring you back at some point to further this conversation. This was fascinating. Thank you so much.

 

Francine: Wonderful. Thank you so much for having me, Gabriella. Lovely, it’s such an honor. 

 

[music]

 

Amanda: Hello, and thank you for listening. This is Amanda Taran. I’m the producer of the DocWorking podcast. If you enjoyed our podcast, please like and subscribe. We would also love it, if you check out our website which is docworking.com. And you can also find us on YouTube, Facebook, Twitter and on Instagram. On Instagram, we are @docworking1, and that is with the number one. When you check us out on social, please let us know what you would like to hear on the podcast. Your feedback really means a lot to us. And if you’re a physician with a story you’d like to tell, please reach out to me at [email protected] to apply to be on the podcast. Thank you again and we look forward to talking with you on the next episode of DocWorking: The Whole Physician Podcast.